Diabetes and Eyes : What the Elderly need to be aware of

Diabetes Mellitus, commonly called “diabetes” is a chronic disorder. The most common variety, which is the adult onset or Type 2 Diabetes, is seen to start in adulthood.

By the time the person has reached the age of 60 plus, the condition would have established itself well. Even though people with this type of diabetes are on regular treatment, the very nature of the disorder is such that it gradually affects the other organs of the body.

The most important organs affected by diabetes and its complications are eyes, heart, kidneys, peripheral blood vessels and nerves. Of course all other organs are also afflicted to some extent. The reason for involvement of these organs is thought to be due to the involvement of small blood vessels which circulate blood and nutrients to these organs.

Involvement of eyes is the most important concern for the elderly with long standing diabetes. As such the elderly are prone to certain conditions of the eyes such as cataract, glaucoma, visual disturbances and weakness of the nerves of vision. Long standing and uncontrolled diabetes can quicken and advance the process of eye diseases. Some of these conditions can quickly worsen the sight and diabetes is considered to be the most important cause of preventable blindness.

What are the warning signs of progressive eye diseases in diabetes, especially in the elderly?

Worsening of vision

Greying of the visual fields

Inability to see clearly from the corners of the eyes

Inability to judge distances and objects appearing from the sides

Inability to face bright light

Multiple or double vision

Sudden onset of patches and holes in vision

Pain and ache behind the eyes

Persistent headache

Sudden loss of vision

All these symptoms can suggest either worsening cataract (opacification of the lens of the eye), glaucoma (rise in eye pressure), retinal hemorrhage and detachment (bleeding into the retina), vitreous hemorrhage (bleeding into the hind chamber of the eye), paralysis of the nerves of the muscles of eye and degeneration of the optic nerve and macular regions (these areas are crucial for the formation of the image).

What can be done about these problems?

The elderly should make it a point to visit an ophthalmologist at least once a year or as often as asked by the ophthalmologist. One should not depend upon the optical outlets for checking the eye sight only. Eye examination is something much more than just checking for the refraction and changing of spectacles. If cataract is detected an early surgery is better than waiting for the cataract to ripen.

Finally the elderly should keep their diabetes under control and cooperating with their diabetologists is of utmost importance, especially if insulin is advised as an essential part of treatment, one should not try to postpone it. Optimal treatment of associated conditions such as high blood pressure and lipid disorders is also very important.

Eye complications of diabetes can be prevented or at least postponed and minimized. This is the most important point that the elderly diabetics should know.

About the Author: Dr. Sudha Tinaikar has been a Practicing Diabetologist and Consultant in Internal Medicine for over 30 years. After completing MBBS from JN Medical College, Belgaum she went on to pursue MD in Internal Medicine from Bangalore Medical College. Later, she went on to work as an Assistant Professor in the Department of Internal Medicine at BR Ambedkar Medical College and subsequently worked as the Head and Coordinator of Internal Medicine at the Columbia Asia Referral Hospital, Yeshwantpur.

A regular faculty in many national and state level conferences in the field of Diabetes and Internal Medicine, Dr. Tinaikar has been chosen as the conjoint overseas faculty of New Castle University of Australia for training doctors in the field of Diabetology and Metabolic Medicine.